The state of Texas’ sustained campaign against Planned Parenthood and other family planning clinics affiliated with abortion providers appears to have led to an increase in births among low-income women who lost access to affordable and effective birth control, a new study says.
The analysis, published Wednesday in the New England Journal of Medicine, documents a significant increase in births among women who had previously received birth control at clinics that no longer get state funding.
By Wade Goodwyn
For the past five years, the Texas Legislature has done everything in its power to defund Planned Parenthood. But it’s not so easy to target that organization without hurting family planning clinics around the state generally.
The researchers found that two years after the cuts, Texas’ women’s health program managed to serve fewer than half the number of women it had before.
The Legislature’s own researchers predicted that more than 20,000 resulting unplanned births would cost taxpayers more than a quarter of a billion dollars in federal and state Medicaid support.
Sixty-nine top US cancer centers, including Seattle’s Fred Hutchinson Cancer Research Institute, have issued a letter urging that adolescents, teens and young adults to be vaccinated against the cancer-causing human papilloma virus (HPV).
Approximately 79 million people in the United States are currently infected with a human papillomavirus (HPV) according to the Centers for Disease Control and Prevention (CDC), and 14 million new infections occur each year. Several types of high-risk HPV are responsible for the vast majority of cervical, anal, oropharyngeal (middle throat) and other genital cancers.
The CDC also reports that each year in the U.S., 27,000 men and women are diagnosed with an HPV-related cancer, which amounts to a new case every 20 minutes. Even though many of these HPV-related cancers are preventable with a safe and effective vaccine, HPV vaccination rates across the U.S. remain low.
Together we, a group of the National Cancer Institute (NCI)-designated Cancer Centers, recognize these low rates of HPV vaccination as a serious public health threat. HPV vaccination represents a rare opportunity to prevent many cases of cancer that is tragically underused. As national leaders in cancer research and clinical care, we are compelled to jointly issue this call to action. Continue reading
Cancer is becoming the No. 1 killer in more and more states as deaths from heart disease have declined, new health statistics show.
Nationwide, heart disease is still the leading cause of death, just ahead of cancer.
While death rates for both have been falling for nearly 25 years, heart disease has dropped at a steeper rate.As a result, cancer moved up to the top slot in 22 states in 2014, according to the latest government figures.
Source: News from The Associated Press
Many pediatricians and family doctors are not strongly recommending the cancer-preventing HPV vaccine to preteens and their parents, contributing to low vaccination rates, a survey of nearly 600 doctors suggests.
The vaccine protects against the human papillomavirus, which is spread through sex and can cause several kinds of cancer, including cervical cancer.
The most common reasons doctors cited for delaying HPV discussions and vaccinations included a belief that patients hadn’t had sex and that parents would object.
OLYMPIA – There’s a new way to donate and show your support for breast cancer screening and testing. Starting Oct. 16, you have a chance to bid on the first batch of breast cancer license plates before they go on sale to everyone, starting in January.
Money raised from the sale of the plates will pay for breast cancer screenings and follow up tests for women with limited or no insurance through the state Department of Health’s Breast, Cervical, and Colon Health Program.
Money raised from the sale of the plates will pay for breast cancer screenings and follow up tests for women with limited or no insurance.
By Stephanie Stephens,
Health Behavior News Service
As many as half to two-thirds of women who’ve undergone hysterectomies or are older than 65 years in the United States report receiving Pap tests for cervical cancer.
This prevalence is surprising in light of the 2003 U.S. Preventive Services Taskforce guidelines recommending that women discontinue Pap testing if they have received a total hysterectomy without a history of cervical cancer and if they are over age 65 years with ongoing and recent normal Pap test results.
Performing these unnecessary tests can result in stress for the patient, increased costs, and inefficient use of both provider and patient time, concludes a new study in the American Journal of Preventive Medicine.
“During this time of health care reform, we could probably use our resources more wisely,” said corresponding author Deanna Kepka, Ph.D., M.P.H., assistant professor at the University of Utah’s College of Nursing and Huntsman Cancer Institute. Continue reading
Cancer Prevention Starts in Childhood
Tips from the US Centers for Disease Control and Prevention
You can reduce your children’s risk of getting cancer later in life.
Start by helping them adopt a healthy lifestyle with good eating habits and plenty of exercise to keep a healthy weight.
Then follow the tips below to help prevent specific kinds of cancer. Continue reading
From the Office of Research on Women’s Health
HPV is a virus that infects your genital region and can cause warts or even cancer. More than 30 types of genital human papillomavirus (HPV) can infect the genital areas of both women and men, including the vulva (area outside the vagina), anus, and the linings of the vagina, cervix, rectum, and skin of the penis.
Most HPV infections go away on their own within a year or two. But persistent HPV infections are now recognized as the major cause of cervical cancer and other less common cancers, such as cancers of the vulva, vagina, anus, and penis.
Studies have also found that oral HPV infection is also a strong risk factor for oropharyngeal cancer (cancer of the throat and tongue).
Genital HPV infections are common and are passed from one person to another through sexual contact. The virus infects the skin and mucous membranes. Most people with HPV do not develop symptoms or health problems.
That is why it is very important for women to have regular Pap smear tests to screen for cervical cancer even if they have received an HPV vaccine. The Pap smear can identify abnormal or pre-cancerous changes in the cervix that a health care provider can remove before cancer develops.
|A vaccine can now protect females from the four types of HPV that cause most cervical cancers and genital warts. The vaccine is recommended for 11- and 12- year-old girls. It is also recommended for girls and women ages 13 to 26 who have not yet been vaccinated or completed the vaccine series. Vaccination against HPV is available also for boys and men, ages 9 to 26, for prevention of genital warts. Talk to your health care provider for more information.|
The types of HPV that can cause cancer are not the same as the types that can cause genital warts. Genital warts usually appear as small bumps or groups of bumps. They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh.
Warts may appear within weeks or months after sexual contact with an infected person or they may not appear at all (even if the person is infected with HPV). If left untreated, genital warts can go away, remain unchanged, or increase in size or number.
|Scientists have shown that condom use may protect you against HPV infection. Condom use has been associated with a lower rate of cervical cancer.|
for more information: www.cancer.gov
From the Washington State Department of Health
The number of gonorrhea cases in Washington is up substantially this year compared to 2012. There have been 3,137 cases through September 2013 compared to 2,350 during the same time in 2012. That’s a 34 percent increase.
Rates have been going up steadily since 2010. Department of Health experts haven’t been able to attribute a specific cause to the uptick. The jump has occurred among men and women in most age groups, but young adults remain the most affected.
Rural and urban counties across Eastern and Western Washington have reported a climb in cases. However, several counties have seen more dramatic upswings, including Spokane, Yakima, Thurston, Kitsap and Benton counties, which are at outbreak levels.
Gonorrhea is the second most common sexually transmitted disease in Washington after chlamydia. It’s spread through unprotected sex with an infected partner. The infection often has no symptoms, particularly among women. If symptoms are present, they may include discharge or painful urination.
Serious long-term health issues can occur if the disease isn’t treated, including pelvic inflammatory disease, infertility and an increased likelihood of HIV transmission.
The department continues to monitor case reports. Local public health officials are actively working with health care providers to ensure that people with gonorrhea and those exposed get appropriate testing and treatment to stop ongoing spread of the disease.
“We’re working closely with local health agencies to actively monitor the rise in cases. We’re especially concerned because of gonorrhea’s resistance to antibiotics used to treat it,” said Mark Aubin, sexually transmitted disease controller for the Department of Health. “It’s important for us to assure every reported case is interviewed so the partners of infected people are identified and receive treatment.”
Despite the increase over the last couple years, Washington rates are still well below the national average.
Health officials urge anyone who is experiencing symptoms, or has a partner that has been diagnosed, to be tested. Routine screenings are recommended for sexually active people.
Prevention methods include consistent and correct use of condoms, partner treatment, mutual monogamy and abstinence.”
To learn more about gonorrhea and find out where you can get tested go to Public Health – Seattle & King County’s Sexually Transmitted Disease webpage.
From the Washington State Department of Health
Immunization rates for Washington teens improved for some vaccines, while holding steady for others, according to a new national study.
In 2012, 86 percent of teens aged 13–17 in our state got a Tdap booster, according to the National Immunization Survey. That’s up from 75 percent in 2011 and tops the national goal of 80 percent.
Tdap is the vaccine that protects against tetanus, diphtheria and whooping cough (pertussis). The increase is welcome news following the recent whooping cough epidemic in Washington.
“We’re delighted that more teens in our state are protected against whooping cough,” said State Health Officer Dr. Maxine Hayes. “Older kids and teens often spread the disease to babies without knowing it. That’s why it’s so important for teens to get a dose of the Tdap vaccine.”
Over the last couple years, more teen girls are getting all three doses of the HPV vaccine, but fewer are getting the initial shot. About 43.5 percent of Washington girls 13 to 17 received the recommended three doses of the vaccine, up 3.5 percent from 2011.
Yet, only 64.5 percent of girls in the same age group got one dose of the HPV vaccine, a 2 percent decrease over the same time.
In 2012, nearly 15 percent of Washington boys aged 13–17 got the first HPV vaccine dose, up 6 percent from 2011. HPV vaccine was originally licensed only for girls and was made available to boys in October 2011.
This, plus a lack of knowledge by health care professionals and parents on the need and recommendation to vaccinate boys, may be why the rate for boys is lower than girls.
HPV vaccinations are recommended for girls and boys to protect against cervical cancer, genital warts and other types of oral and anal cancers.
Health care professionals should talk with parents about the importance of all kids getting HPV vaccinations starting at age 11 and 12. Kids in this age group have a stronger immune response compared to older kids.
“Parents want what’s best for their kids and want them to live happy, healthy lives,” Hayes said. “They can lower their children’s risk for HPV or cancer by getting them vaccinated.”
Nearly all sexually-active men and women will get at least one type of HPV at some point in their lives. HPV is most common in people in their teens and early 20s. That’s why it’s important for kids to get vaccinated before they start having sex. The vaccine doesn’t protect against any HPV strains someone already has.
Our state’s vaccination rate for two or more doses of chickenpox vaccine rose 8 percent in 2012. The rate for one dose of meningococcal vaccine rose slightly, from 69.4 percent in 2012 to 71.2 percent in 2011.
No-cost vaccines are available to kids up to 19-years-old through health care providers who participate in the state’s Childhood Vaccine Program.
Participating health care providers may charge for the office visit and an administration fee to give the vaccine. People who can’t afford the administration fee can ask for it to be waived.
For help finding a health care provider or an immunization clinic, call your local health agency or the WithinReach Family Health Hotline at 1-800-322-2588.
By Sharyn Alden, HBNS Contributing Writer
Research Source: Journal of Adolescent Health
‘Health care providers are missing opportunities to improve teens’ vaccination coverage, reports a new study in the Journal of Adolescent Health.
Recommendations for routine vaccination of meningococcal (MCV), tetanus, diphtheria, and acellular pertussis (Tdap) and human papillomavirus (HPV) in adolescents are fairly new and many parents may be unaware of the need for adolescent vaccines.
“Our study found that when adolescents who are vaccine-eligible come to their health care provider for preventive visits, there are missed opportunities for vaccination. Adolescents who come in for non-preventive visits have even greater missed opportunities,” said lead author Rachel A. Katzenellenbogen, M.D., assistant professor of pediatrics at the University of Washington and Seattle Children’s Hospital.
“Our data found that adolescents who have an appointment come into their health care provider’s office and leave without receiving all three recommended vaccines—Tdap, HPV and MCV,” Katzenellenbogen said.
Adolescents need fewer preventive care visits than infants and are a relatively new population to be targeted for vaccination when compared to infants and children, she explained.
Katzenellenbogen and her colleagues analyzed vaccination rates for 1,628 adolescents aged 11- 18 with 9,180 visits to health care providers between 2006 and 2011.
All of the teens in the study were seen at a pediatric clinic in Seattle. During that time frame, 82 percent missed being vaccinated against MCV, 85 percent missed Tdap and 82 percent missed the first dose of HPV1.
“If parents know to expect that their adolescent should receive three vaccines when they turn 11 or 12, they may be more likely to schedule a preventive visit or bring up vaccination with their child’s health care provider during any office visit,” commented Kristen A. Feemster, M.D., assistant professor in the division of infectious diseases at the University of Pennsylvania School of Medicine.
Feemster said she was not surprised that missed opportunities occur because there are many challenges to implanting adolescent vaccine recommendations. “It is more challenging, for example, to establish eligibility for adolescent vaccines—many registries do not yet reliably capture adolescent vaccination. Providers may have questions or concerns about the recommended schedule, plus adolescents may seek care in alternative locations where it is particularly difficult to establish eligibility.”
The researchers suggest that improved vaccine tracking and screening systems, such as provider prompts through electronic health records or manual flags by nurses or medical assistants, would enable providers to more easily identify those teenagers eligible for vaccines at all visit types.
The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.
By Bill Robinson
NCI Cancer Bulletin
According to the latest national data, overall death rates from cancer declined from 2000 through 2009 in the United States, maintaining a trend seen since the early 1990s.
Mortality fell for most cancer types, including the four most common types of cancer in the United States (lung, colon and rectum, breast, and prostate), although the trend varied by cancer type and across racial and ethnic groups.
The complete “Annual Report to the Nation on the Status of Cancer, 1975–2009” appeared January 7 in the Journal of the National Cancer Institute.
The report also includes a special section on cancers associated with the human papillomavirus (HPV) that shows that, from 2008 through 2010, incidence rates rose for HPV-associated oropharyngeal, anal, and vulvar cancers.
HPV vaccination rates in 2010 remained low among the target population of adolescent girls in the United States.
As in past years, NCI, the American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), and the North American Association of Central Cancer Registries (NAACCR) collaborated on the annual report.
Cancer incidence data came from NCI’s Surveillance, Epidemiology, and End Results (SEER) database and the CDC, with analyses of pooled data by NAACCR. Mortality data came from the CDC’s National Center for Health Statistics.
Incidence Rates Vary, Death Rates Continue to Drop
Among men, the overall rate of cancer incidence fell by an average of 0.6 percent annually from 2000 through 2009. Cancer incidence rates were stable among women during the same time period and rose by 0.6 percent per year among children. (See the table.)
“The continuing drop in cancer mortality over the past two decades is reason to cheer . . . The challenge we now face is how to continue those gains in the face of new obstacles, like obesity and HPV infections.”
During the same period, death rates among men fell for 10 of the 17 most common cancers and rose for three types of cancer. Death rates among women fell for 15 of the 18 most common cancers and also rose for three types of cancer.
“The continuing drop in cancer mortality over the past two decades is reason to cheer,” said ACS Chief Executive Officer Dr. John R. Seffrin in a statement. “The challenge we now face is how to continue those gains in the face of new obstacles, like obesity and HPV infections. We must face these hurdles head on, without distraction, and without delay, by expanding access to proven strategies to prevent and control cancer.”
HPV Vaccination Rates Low
The special section on HPV-related cancers showed that from 2000 through 2009, incidence rates for HPV-associated oropharyngeal cancer increased among white men and women, as did rates for anal cancer among white and black men and women. Incidence rates for cancer of the vulva also increased among white and black women.
However, cervical cancer rates declined among all women except American Indian/Alaska Natives. In addition, cervical cancer incidence rates were higher among women living in lower-income areas.
The annual report also showed that, in 2010, fewer than half (48.7 percent) of girls ages 13 through 17 had received at least one dose of the HPV vaccine, and only 32 percent had received all three recommended doses, a rate that fell well short of the Department of Health and Human Services’ Healthy People 2020 target of 80 percent.
The rate is also much lower than vaccination rates reported in Canada (50 to 85 percent) and the United Kingdom and Australia (both higher than 70 percent).
Vaccination series completion rates were generally lower among certain populations, including girls living in the South, those living below the poverty level, and Hispanics.
“The influence that certain viral infections can have on cancer rates is significant and continued attention to the effect[s] of HPV infection, in particular, on cervical cancer rates is critical,” said NCI Director Dr. Harold Varmus in a statement. “It is important, however, to note that the investments we have made in HPV research can only have the tremendous payoff of which they are capable if vaccination rates … increase.”
Cancer Incidence and Mortality Rates, 2000–2009
The NCI Cancer Bulletin is an award-winning biweekly online newsletter designed to provide useful, timely information about cancer research to the cancer community. The newsletter is published approximately 24 times per year by the National Cancer Institute (NCI), with day-to-day operational oversight conducted by federal and contract staff in the NCI Office of Communications and Education. The material is entirely in the public domain and can be repurposed or reproduced without permission. Citation of the source is appreciated.
Immunization rates among teens in Washington appear to be improving for some vaccines, while holding steady or dropping slightly for others, according to the 2011 National Immunization Survey that has just been released.
Although more teens 13–17 years of age are vaccinated against serious diseases than in previous years, teen immunization rates remain below state goals, Washington state health officials said.
“Some diseases, such as chickenpox, are more dangerous for older teens than for younger kids,” said Secretary of Health MarynSelecky. “Missing or delaying even one vaccine puts them at risk for catching and spreading disease. Parents should get their teenagers immunized when the teen sees a health care provider for sports physicals, injuries, or mild illnesses.”
Even with some gains in teen immunization rates, the survey shows that Washington is not meeting state and national vaccination goals, state health officials said.
Those goals include vaccinating 90 percent of teens with the vaccine that protects against chickenpox (varicella) and 80 percent coverage against whooping cough (pertussis), human papillomavirus (HPV), and meningococcal disease.
“The whooping cough epidemic reminds us that it’s vital for teens to get immunized on time,” said Selecky. “Immunizing teens is as important as immunizing young children – it protects the teens and everyone around them, especially babies who are too young for vaccination. Every teen should be up-to-date with all recommended vaccines.”
The percentage of teens getting the whooping cough vaccine, Tdap, improved from 71 percent in 2010 to 75 percent in 2011; the national average is 78 percent.
Washington state is in the midst of the worst whooping cough epidemic in 70 years with nearly 3,800 cases reported so far this year
Whooping cough vaccines are recommended for all kids, teens, and adults.
Most people get a series of whooping cough vaccines as kids, but protection wears off over time. That’s why a dose of Tdap is recommended for everyone age 11 and older. Booster shots play a key role in the fight against diseases that vaccines can prevent.
State’s HPV vaccine rate on of the nation’s highest.
Washington state continues to have one of the highest first-dose HPV vaccination rates for females in the nation; however, the estimated rate decreased from 69 percent to 67 percent and only 40 percent of teen girls got all three doses needed to be fully protected.
For the first time, the national survey included HPV vaccination rates for males; 9 percent got one dose of the vaccine compared to the national average of 8 percent.
State health officials are urging health-care providers to talk with parents about the importance of all children getting the HPV vaccine at age 11-12. Children in this age group have a stronger immune response compared to older ages.
All recommended vaccines are offered at no-cost for children up to age 19 in Washington through healthcare providers participating in the state’s Childhood Vaccine Program.
Some providers may charge for an office visit and/or a fee to give the vaccinations (called an administration fee). People who can’t afford the administration fee can ask the health care provider to waive the cost.
More information on immunizations is on the Department of Health Office of Immunization and Child Profile website (doh.wa.gov/cfh/Immunize). The National Immunization Survey (cdc.gov/nis/) is available from the Centers for Disease Control and Prevention.
By Monica Richter, MD, PhD
One of the most important recent advances in women’s health is a vaccine against human papillomavirus (HPV). The HPV vaccine protects against serious health problems such as cervical cancer and other less common cancers.
The first HPV vaccine was approved in June of 2006 after testing in thousands of people around the world.
Two HPV vaccines are currently licensed by the FDA and recommended by the Centers for Disease Control and Prevention (CDC): Gardacil is approved for girls or boys ages 9 to 26, and Cervarix is approved for girls 10 through 25 years of age.
HPV is the most common sexually transmitted virus in the United States. More than half of sexually active men and women are infected with the virus at some time in their lives.
In addition to causing cervical cancer, HPV can cause vaginal and vulvar cancer in women, and other types of cancers in both men and women. It can also cause genital warts and warts in the throat.
But good news! The HPV vaccine can prevent most cases of cervical cancer in women. It can also prevent vaginal and vulvar cancer in women and genital warts and anal cancer in both men and women. Protection from the vaccine is long-lasting.
While we all hope that young teens are abstaining from sexual activity, it is important to vaccinate girls long before their first sexual contact.
In addition, the response to the vaccine is stronger in younger girls and for this reason, we recommend vaccinating girls at age 11 or 12 years. The vaccine is given as a 3-dose series over 6 months.
Both vaccines are available for women, but only one of them can be given to men also.
Vaccines have undergone a lot of scrutiny in recent years, but all of the available scientific evidence confirms their safety and efficacy.
In spite of this, many false rumors are circulating and I continue to be confused by the number of parents who decline the vaccine for their daughters. As a mother and a pediatrician,
I gave my daughter the HPV vaccine as soon as it became available and I urge all parents to do the same.
For more information on the HPV vaccine, visit www.cdc.gov/vaccines.
About Monica Richter, MD, PhD
Dr. Monica Richter is a board certified pediatrician with Valley Children’s Clinic. Over the past 18+ years Dr. Richter has helped hundreds of pubescent girls navigate the physical and emotional aspects of their changing bodies and psyches, including menstruation, body changes, sexuality and how babies are conceived, through her free seminar, As Girls Grow Up. She also teaches BodyWorks, an eight-week health education program developed by the Dept. of Health & Human Services. Bodyworks is designed to provide parents and caregivers of teenage girls and boys ages 9 to 16 with tools to improve family eating and activity habits. Originally from Manhattan, Dr. Richter is married with two grown children. In her spare time she enjoys reading and knitting.
Valley Children’s Clinic is located at 4011 Talbot Road S., Suite 220, in Renton. Phone: 425.656.5300; www.valleychildrensclinic.org